﻿<section id="orderform" class="gray-bg padding-top-bottom">
    <div class="container">
        <header class="section-header text-center">
            <h2>Order Form</h2>
        </header>
        <form action="http://angelostudio.net/microstore/index.html" method="post" novalidate id="order-form">
            <div class="row">
                <!-- <div class="form-group"> -->
                <!-- <div class="row"> -->
                <div class="col-sm-4 col-md-4">
                    <div class="form-group">
                        <label class="show"><input class="mycheck" type="checkbox" checked data-price="700"> Bed (<strong>$700</strong>)</label>
                    </div>
                </div>
                <div class="col-sm-4 col-md-4">
                    <div class="form-group">
                        <label class="show"><input class="mycheck" type="checkbox" data-price="400"> Nightstand (<strong>$400</strong>)</label>
                    </div>
                </div>
                <div class="col-sm-4 col-md-4">
                    <div class="form-group">
                        <label class="show"><input class="mycheck" type="checkbox" data-price="600"> Hammock (<strong>$600</strong>)</label>
                    </div>
                </div>
                <!-- </div> -->
                <!-- </div> -->
                <div class="col-sm-6 col-md-6 contact-info">
                    <p class="text-center"><strong>Payment Method</strong></p>
                    <div class="row">
                        <div class="col-sm-8 col-md-8">
                            <div class="form-group">
                                <label class="control-label">Name</label>
                                <input name="Card number" placeholder="Card number" class="form-control input-lg" type="text">
                            </div>
                        </div>
                        <div class="col-sm-4 col-md-4">
                            <div class="form-group">
                                <label class="control-label">Code</label>
                                <input name="Code" placeholder="Code" class="form-control input-lg" type="text">
                            </div>
                        </div>
                    </div>
                    <div class="row">
                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="control-label" for="contact-mail">month</label>
                                <div class=" controls">
                                    <select class="form-control">
                                        <option>January</option>
                                        <option>February</option>
                                        <option>March</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="control-label" for="contact-mail">year</label>
                                <div class=" controls">
                                    <select class="form-control">
                                        <option>2014</option>
                                        <option>2015</option>
                                        <option>2016</option>
                                        <option>2017</option>
                                        <option>2018</option>
                                    </select>
                                </div>
                            </div>
                        </div>
                    </div>
                    <p class="text-center"><strong>Information</strong></p>
                    <div class="row">
                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="control-label">Name</label>
                                <input name="First name" placeholder="First name" class="form-control input-lg" type="text">
                            </div>
                        </div>
                        <div class="col-sm-6 col-md-6">
                            <div class="form-group">
                                <label class="control-label">Last Name</label>
                                <input name="Last name" placeholder="Last name" class="form-control input-lg" type="text">
                            </div>
                        </div>
                    </div>
                    <div class="form-group">
                        <label class="control-label">Email</label>
                        <input name="email" placeholder="Your email" class="form-control input-lg" type="email">
                    </div>
                    <p class="text-center"><strong>If you have Coupon code</strong></p>
                    <div class="form-group">
                        <label class="control-label">Coupon</label>
                        <input name="Coupon" placeholder="Coupon code" class="form-control input-lg" type="text">
                    </div>
                </div>

                <div class="col-sm-6 col-md-6">
                    <p class="text-center"><strong>Delivery address</strong></p>
                    <div class="form-group">
                        <label class="control-label">Street</label>
                        <input name="street" placeholder="Street address" class="form-control" type="text">
                    </div>
                    <div class="form-group">
                        <label class="control-label">City</label>
                        <input name="city" placeholder="City" class="form-control" type="text">
                    </div>
                    <div class="form-group">
                        <label class="control-label">Country</label>
                        <input name="Country" placeholder="Country" class="form-control" type="text">
                    </div>
                    <div class="form-group">
                        <label class="control-label">postcode</label>
                        <input name="postcode" placeholder="Post code" class="form-control" type="text">
                    </div>
                    <table class="table">
                        <thead>
                            <tr>
                                <th colspan="3" class="text-center">Order sumary</th>
                            </tr>
                        </thead>
                        <tbody>
                            <tr>
                                <td>Shipping cost:</td>
                                <td></td>
                                <td class="text-right">Free</td>
                            </tr>
                            <tr>
                                <td>Total:</td>
                                <td></td>
                                <td id="total" class="text-right">$700.00</td>
                            </tr>
                        </tbody>
                    </table>
                    <p>
                        <button name="submit" type="submit" class="btn btn-store btn-block">Order Product</button>
                    </p>
                    <input type="hidden" name="submitted" id="submitted" value="true">
                </div>
            </div>
        </form>
    </div>
</section>